L-carnitine (LC) is a natural compound crucial for transporting long-chain fatty acids into mitochondria for ATP production. It is found mainly in red meat, fish, and dairy products, in addition to being synthesized by the body. LC is supplemented in patients with organic acidemias since it corrects secondary carnitine deficiency and accelerates the removal of the accumulated acyl organic acid derivative groups. Recently, it was also shown to behave as an antioxidant and an anti-inflammatory agent in various pathological conditions like hypertension, diabetes, and neurodegenerative diseases. Inflammation is a complex response to tissue damage or infection associated with oxidative stress. LC has been implicated in reducing inflammatory cytokines and other biomarkers. Recent studies suggest that LC supplementation reduces inflammation in chronic kidney disease, cardiovascular disease, and neuroinflammation. LC supplementation has been effective in reducing inflammatory markers like C-reactive protein (CRP) and interleukins (IL-6, TNF-α) in various pathologies, including septic shock and polycystic ovary syndrome (PCOS). It has also been shown to reduce cardiovascular events in patients with end-stage renal disease. In experimental models, LC revealed neuroprotective effects, improving memory and reducing neuronal death. Additionally, in spinal cord ischemia-reperfusion injury and acute myocardial infarction, LC treatment diminished inflammation and oxidative stress while improving neurological and cardiac functions. In conclusion, LC supplementation demonstrates significant potential properties in reducing inflammation and improving health outcomes in various pathological conditions, making it a subject of increasing interest in medical research. This article aims to review the literature on the anti-inflammatory and antioxidant effects of LC in different pathologies.